My classroom accommodations in college are based on what I had in high school. I definitely recommend getting classroom accommodations if you qualify or have used them in the past. Sometimes students think they won't need them, so they don't get them. If you don't end up needing them, that's perfectly fine, but it's easier to decide not to use them than it is to decide halfway through the semester that you wish you had them.
All accommodations are arranged in a completely confidential way among you, the student affairs office, and the professors with whom you share your needs. No one else will know about your accommodations unless you decide to share that information.
My needs are minimal and I've gotten pretty good at figuring out what classes I will need accommodations in. I type my written tests on a computer and use extra time during exams. To do this, I use the testing room in the Student Affairs Office, which has the computer and a proctor to track your extra time. About a week before the test, I email to request a time to use the room. I notify my professor what time I'll be taking the test; it is delivered to the proctor beforehand and the proctor returns it to the professor when I'm done.
Accommodations like this are arranged through Joyce Stern, dean of student academic support and advising. After meeting with her, you receive a set of letters that you can give to professors explaining your needs and accommodations. It makes it easier to explain certain accommodations; for example, I simply explain to them what my Livescribe pen is, and that I use it to record lectures.